Provider Demographics
NPI:1306653183
Name:PHILBECK, CAROLINE MARGARET (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:MARGARET
Last Name:PHILBECK
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 BLACKSNAKE RD
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28164-1627
Mailing Address - Country:US
Mailing Address - Phone:704-477-4496
Mailing Address - Fax:
Practice Address - Street 1:111 KILSON DR STE 104
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8218
Practice Address - Country:US
Practice Address - Phone:980-317-0985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17368225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist